The Health Law Firm

FEBRUARY 20, 2018

million to settle a whistle blower lawsuit alleging its pharmacies caused federal health programs to overpay for prescription drugs by not telling the government about discounted prices. The department store chain withheld certain information from Medicare Part D, Medicaid and Tricare, the Department of Justice (DOJ) said.

Overpayments 40

Overpayments Overpayment Medicaid Medicaid 40

AIHC

NOVEMBER 29, 2023

Medicare changed reimbursement methodology in the 1980s by introducing Relative Value Units (RVUs) and the RBRVS (Resource-Based Relative Value System) for physician reimbursement. As the cost of providing care grew, payers started instituting methods to curb expenses and how claims were paid. healthcare system were exorbitant.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Health Law Advisor

FEBRUARY 10, 2023

Lowest Total Recoveries Since 2008 Record-Shattering Number of New Cases Filed Health Care and Life Sciences Cases Continue to Dominate On February 7, 2023, the U.S. billion was recovered in qui tam cases in which the government declined to intervene. 1] While total recoveries exceeded $2.2 Last year, $1.2 1] [link]. [2] 1] [link]. [2]

Fraud 52

Fraud COVID-19 Governance Medicaid 52

American Medical Compliance

FEBRUARY 23, 2023

If a company is recognized as a covered entity, it must adhere to the HIPAA laws and regulations governing the privacy and security of health information. Health plans, healthcare providers, healthcare clearinghouses, and Medicare part D plans are all examples of covered entities. The government can fine providers up to $1.5

HIPAA 52

HIPAA Compliance Governance Health Insurance 52

Health Populi

MARCH 7, 2018

There’s an old saw that the US government is an insurance company with an army” quips @PaulKrugman @HIMSS #HIMSS18 #HX360 #Healthinsurance #Medicare #Healthcare #Healthcosts. More #nurses than #miners #healthcosts. Lowest-cost is 1st model #HIMSS18 #HX360 @HIMSS #healthcosts #heatlhIT.

ACA 48

ACA Governance Nurses Medicare 48

Healthcare Law Blog

DECEMBER 12, 2022

The Centers for Medicare & Medicaid Services (“CMS”) temporarily approved certain telehealth flexibilities during the PHE. The Ryan Haight Act of 2008 generally requires a prescribing practitioner to have conducted at least one in-person medical evaluation of a patient prior to prescribing controlled substances via telehealth.

COVID-19 52

COVID-19 Fraud Telemedicine Public Health 52

Verisys

DECEMBER 22, 2021

. – Donald Potts has helped healthcare customers define business problems and design innovative solutions since he started at Optum in 2008. As a product manager at the healthcare technology and services company Verisys , he guides many of the solutions that support health plans, health systems, and state Medicare and Medicaid agencies.

Compliance 52

Compliance Regulatory Compliance Healthcare information Technology Health Insurance 52

Hall Render

JANUARY 21, 2022

In 2008, the plaintiff physician joined a Michigan-based health system (the “Hospital”) as a member of its medical staff. Plaintiff alleged that his application for reappointment and for medical staff privileges was rejected in retaliation for his “whistleblowing” to the federal government. Case Background. JCC vote) took place.

Hospitals 40

Hospitals Medicare Medicare Governance 40

Health Care Law Brief

APRIL 11, 2022

For example, in October, 2008 , the OIG allowed a non-profit organization that provides outpatient treatment services for patients with psychoactive substance abuse dependence to offer incentives in the form of $5–$10 gift cards to motivate those patients to adhere to their treatment plans, which include urine drug screening and counseling sessions.

Fraud 52

Fraud Medicare Medicare Compliance 52

Health Care Law Brief

FEBRUARY 8, 2024

In addition to those provisions that look to extend current government programs, the HMH Bill proposes the following new initiatives: Provider Specific Provisions : Transforming Safety Net Hospitals. billion to fund Medicaid, $4.8 billion to address serious mental illness and $6 billion in federal funding through the 1115 Waiver.

Medicaid 52

Medicaid Medicaid Nurses Licensing 52

Bill of Health

SEPTEMBER 9, 2022

Consider, for example, the Coronavirus State and Local Fiscal Recovery Funds Program (SLFRF) — enacted as part of the American Rescue Plan Act — which provided $350 billion in flexible aid to state, local, tribal, and territorial governments. Consider that between 2008 and 2020, U.S. public health expenditures fell by 30 percent.

Public Health 362

Public Health COVID-19 Public Health Professionals Governance 362

Healthcare IT Today

FEBRUARY 7, 2024

State governments are also roped in thanks to their Prescription Drug Monitoring Programs (PDMPs). History of EPCS Kyle Zebley, head of public policy American Telemedicine Association (ATA) , says that Congress called on the DEA to implement a policy for a special controlled substance registration process in 2008.

Telemedicine 105

Telemedicine Doctors COVID-19 Medicare 105

Health Law Advisor

MARCH 7, 2023

Background on the Ryan Haight Act The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (the “Ryan Haight Act”) made certain amendments to the CSA which established controls on the remote prescribing of controlled substances. 18 U.S.C. §

Telemedicine 52

Telemedicine COVID-19 FDA Compliance 52

HIT Consultant

JANUARY 5, 2022

However, as a board-certified physician in addiction medicine and chief medical officer of a nationwide addiction medicine practice, waiting on government funding was not an option as we treated patients struggling with opioid use disorder (OUD) during the COVID pandemic.

US Department of Health and Human Services 98

US Department of Health and Human Services Telemedicine Governance Medicaid 98

Healthcare IT News - Telehealth

MARCH 18, 2022

For many years, mental health has lagged between physical health both in access to treatment and reimbursement – this is despite the mandates of the Mental Health Parity and Addiction Equity Act of 2008. Fortunately, government, investors and startups are working together to close some of these care gaps.

Medicaid 199

Medicaid Medicaid COVID-19 Telemedicine 199

YouCompli

AUGUST 16, 2023

For example, let’s say there was an audit that identified a billing error which resulted in a six-figure repayment to Medicare. For example, let’s assume you have been made aware that the organization inadvertently billed Medicare for a particular procedure in error (e.g., the wrong procedure code was billed).

Compliance 52

Compliance HIPAA Medicare Medicare 52

Health Populi

SEPTEMBER 9, 2022

In their latest look into consumers’ views on business in America, Gallup found that peoples’ ratings on business fell to their lowest ratings overall since 2008. Health Populi’s Hot Points : For some context, remember that 2008 was the advent of the Great Recession.

Prescription Drug Pricing 62

Prescription Drug Pricing Health Insurance Medical Billing Doctors 62

HIT Consultant

MARCH 1, 2022

Consider more CMS oversight : Between 2008 and 2018, states spent a total of $44.1 billion on their MES and eligibility and enrollment systems, according to a 2020 report by the Government Accountability Office (GAO). Centers for Medicare and Medicaid Services (CMS) reimbursed states $34.3 billion of that amount.

Medicaid 52

Medicaid Medicaid Overpayments Overpayment 52

Health Populi

APRIL 10, 2019

The study analyzed medical claims for millions of patients, both commercially insured and enrolled in Medicare. In no state did the rate of diabetes decline in the ten years between 2008 and 2018. For families with a member with diabetes, the household economic burden was $3,150, or 5.1% of family income.

Prescription Drug Pricing 119

Prescription Drug Pricing Medicare Medicare Governance 119

Drug & Device Law

OCTOBER 10, 2022

The manufacturer sought to cover Medicare patients’ Part D cost-sharing obligations for the drug – which were estimated at approximately $13,000 per year – but the OIG said “no thanks,” and the Second Circuit has affirmed that outcome. That being said, Medicare does not cover the entire cost of the drug. 1320a-7b (“AKS”). 124, 131 n.3

Medicare 52

Medicare Medicare FDA Prescription Drug Pricing 52

Drug & Device Law

JANUARY 30, 2023

440 (2008) Buckman was not cited at all in the Merck Sharp & Dohme Corp. Plaintiffs Legal Committee , 531 U.S. Kent , 552 U.S. Albrecht , 139 S. 2019), or Mutual Pharmaceutical Co. Bartlett , 570 U.S. 472 (2013), implied preemption decisions, cited only by the dissent in Wyeth v. Davidowitz , 312 U.S. Moran , 536 U.S. Walsh , 538 U.S.

FDA 72

FDA Fraud Governance Medicare 72

Drug & Device Law

MARCH 31, 2022

Thus, we were pleased that the Medicare recipient in Dobson v. But because this claimant’s intractable nausea and vomiting arose from a spinal cord injury, not the particular cancer mentioned in Drugdex, the government denied coverage. But it mattered to the folks that administered Medicare. 1396r-8(k)(6).

Medicare 52

Medicare Medicare FDA Governance 52